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That is the question I am confronting right now. And while I generally feel I am an expert by experience as a survivor of childhood sexual abuse, I don’t instinctively know the answer to this question.

Logic, rationality, the thinking things in life can of course supply an answer straight away – he was probably both. But to jump to that conclusion without truly knowing why is lacking somehow. I need a bit more to go on; my education didn’t include the rigours of studying jurisprudence so I don’t know the questions to ask about criminality. My education also didn’t include any aspects of psychiatry or other clinical disciplines which might help the sickness bit of it (I’m discounting my biology O level here).

The things I have studied – literature and languages, history, a touch of politics, art, and quasi philosophy (ie applied not pure) are not helping a jot. In fact they are making the intellectual line I’m trying to walk all the more wavy. It’s all perspectives, approaches, angles, arguments and interpretations, when what I really want is an equation:

I only started to think about this because the news – it’s always the bloody news – was full of Jimmy Savile and the BBC and the extent of his ‘activities’. That is my euphemism. I can’t remember theirs, something like ‘inappropriate sexual behaviour’.

Then everything came crashing down.

I realised that the reason everyone is so exercised is because what he did was criminal. And the frequency, severity, calculated and opportunistic nature of what he did could be paralleled with my own experience at the hands of a family member. If Jimmy Savile committed crimes; then what my maternal grandfather did to me over many years was, by this definition, criminal.

To see this so suddenly is terrifying. It means that I have experienced something, indeed many things, which are ‘officially wrong’. Wrong according to society, wrong according to the legal system, wrong in the eyes of most individuals. There is an externally validated yardstick to hold up, against which his actions could and would be measured.

(As an aside I looked at the Crown Prosecution Service sentencing manual. I was seeking definitions and an external perspective. It’s illuminating and depressing at the same time to know what are considered to be issues of culpability and harm, aggravating and mitigating factors, and the fact that the sentencing guidelines do allow previous good character of the offender to be taken in to account. Would it really make a difference if someone had previously been convicted of, say, fraud?)

So this recent realisation says criminal. Using the only approach available to me – looking at other situations, making comparisons, and then arriving at some conclusions – gave me that answer.

But then there’s another issue to be considered: that my abuser was a sick man. I have no way of knowing if this was true, but his actions could suggest that he was disturbed and ill for much of his life. I know little about him beyond a few bare details – that he was one of many children and that he became very hard of hearing early in his life. That’s it. I am not aware of any psychiatric or clinical diagnosis.

(As a further aside I tried to find an accessible explanation of what this illness might be. It was a relatively fruitless quest; I did stumble across an article about psychiatric co-morbidities in sex offenders which was more disturbing than the CPS sentencing manual.)

So where does this leave me?

Until now my response to my abuse has emanated from my own reactions to it. Applying an external perspective to these actions is very different. It both validates and undermines. To know that there is a measurable punishment for what he did – fourteen years behind bars – means it was a ‘something’. Society is saying – you, perpetrator, are responsible and you will pay a price. So it is a validation of what I now know were horrific experiences.

If I suffered what I did because he was deeply disturbed and unwell I am left feeling uneasy. I can’t hold him responsible in the same way and there is so much more to understand that I might not have the information ever to do. That undermines something, not necessarily my experience, but my sense of ‘mastery’ of this particular subject. Would I, could I, ever muster the compassion necessary to explore this?

I’m setting up a conundrum that cannot actually be solved. I know there isn’t a mathematical formula or equation to give me the answer. But I am holding on to another bit of maths that I’ve always liked – the Venn diagram.

A picture to make more intelligible some factors that gave rise to my abuse. They are overlapping and confusing for me – but at least I can see them while I search for a clarity that doesn’t exist.

Trusty old Wikipedia tells me that a sequela (usually used in the plural, sequelae) is a “pathological condition resulting from a disease, injury, therapy, or other trauma.” Basically, something medical and noticeable, an identifiable condition that happens as a consequence of something else.

I was prompted to find a definition after I read an article in the New Statesman by Dr Phil Whitaker. It was an article that I applauded and that also made me sigh. He tackled an important issue: many women who have been sexually abused or assaulted are often unable to undergo primary healthcare checks and screening that require intimate examinations.

He related the tragic story of Martha, a woman in her late thirties, who, despite suffering ongoing infections (which is why she presented for treatment), was unable to have an internal examination. She revealed to him that she had been sexually abused in childhood. The terrible outcome of this was that she had advanced cervical cancer and died shortly afterwards. A psychological sequela (painful in itself) and a physiological sequela (in this case terminal).

Dr Whitaker is so right to bring to light just one of the consequences of what we know thousands of children suffer, which continue throughout adulthood. And that is what I applaud. When I put my ‘outsider’ head on, and read the article from the perspective of someone who has not experienced or is not really in the know about the impact of sexual abuse, it raises awareness of something so important. The long term impact (and cost – human and fiscal) of abuse is complex, comes from all sorts of sources and is not always obvious. It makes you think.

As an ‘insider’ (someone who is a survivor of child sex abuse) there was something in the article that just made me sigh. I’ve written before about the casual use of labels and categorisations, which I find can mask the reality of what it’s like to live with the consequences of abuse. I do not have this criticism of Dr Whitaker’s article – it is sensitively written, insightful and avoids generalisations. But I still have a sense that I, as an abuse survivor, am being written about, without being able to identify with the description or the perspective.

So, I attribute a portion of my sigh to not wanting to be part of a ‘group’ defined by someone else, not me. Another portion of my sigh goes to that familiar, self-imposed distance: be outside it all, deal with it by not engaging with it, pretend, pretend, pretend. There’s a small portion of my sigh that comes from just wanting to be able to flick through a magazine or newspaper and not be confronted by the unwanted. But the final, most important portion is the horrible jolt of recognition. I know the psychological sequelae of my abuse mean I am taking risks with physical health:

I’ll hold my hands up and say that I’m 44 and I’ve had one smear test in 20 odd years. This is bad. One doctor said to me “it’s the best insurance policy you can have”. Yes, of course – and I’d gladly do it if it meant filling out a form and paying an annual premium. Another GP, to whom I disclosed my childhood experiences, listened and offered (unprompted by me) to stop the smear reminders. I understand her motivation but it isn’t the answer.

I’ll also tell you that my trips to the dentist are infrequent-to-nonexistent – I’m waiting for the toothache that will force me to go. It will be a terrifying relief, as only that physical pain crisis will get me in the chair to have a stranger make me hold my mouth open and put things in it. To tell them I’m a nervous patient underplays it somewhat.

And several weeks ago I managed to get myself to the optician. Another basic health check that I have avoided…for nine years. Recently I fell over several times in quick succession simply because I could no longer see properly; the prescription in my glasses was too old to be useful. But sitting in the chair, in the dark, in a small room, unable to move, with a stranger at such close proximity is very, very hard. Of course I survived to see another day, but I didn’t relish it.

Some days the ramifications of abuse can feel overwhelming – a chain of “sequelae” not just one or two. Martha’s story is a stark reminder that sometimes it is really bad. But amongst all this I found a chink of light: mybodybackproject.com. This project gives a bit of hope to people like me (and countless others out there) who at the moment can’t access simple checks that might save our lives.

So, I am a victim and I’m a survivor – of childhood sexual abuse. The recent reports from Rotherham over the past three weeks fill me with absolute rage, heartfelt sadness and overwhelming desperation at the ‘wrongness’ of what happened there. I don’t yet have the courage to speak out openly about what happened to me, however I have been able to seek support and pay for therapy to help me process and live alongside the deeply traumatic experiences from my past.

Having worked at a national level in organisations representing the institutions that have played their part in failing the 1400 girls in Rotherham and countless other children and young people who are abused, I know that the life chances for young people in the “looked after” system are seriously diminished. I also know that the funding available to provide the kind of individual mental health care and support they need to reclaim even a small part of their lives is pitiful. Against this measure I consider myself ‘lucky’.

We organise society, public services and our lives at a macro level by relying on (often sophisticated) categorisation, based on research and statistics, and guided by policies and politicians. These can be important. But there is such a danger in using only this approach to shape our response, practical, moral and emotional, to the victims and survivors. A tick list of symptoms, a set of diagnoses, a menu of responses – it just doesn’t cut it.

In confronting this and all the other instances of abuse recently reported as a “collective tragedy” we must not let it mask the fact that we are talking about tens of thousands of individual tragedies: lives severely curtailed by fear and terror, childhoods lost, and the prospect of a lifetime of mental and physical health problems. Even in the title of this blog I use the phrase “Rotherham” as a shorthand to refer to (at least) 1400 shattered lives. Of course it is a device. I am conflicted in using it; I know a little of what they suffered, yet I want to get the message out there.

Samantha Morton’s piece in the Guardian today is brave and stark. We need to hear more of these stories. I do not want to see any of these girls’ experiences belittled by their very scale, nor do I want the scale of the response needed to mean that we are blunt and unsophisticated. In writing this I had the familiar feeling of ‘who am I to be saying all this?’. Suddenly I realise I have as much right as anyone to talk out on this – I have been abused.

I wrote this poem recently to express how it feels from my perspective.